A substantial proportion of older adults with diabetes may be overtreated, according to research published January 12 online ahead of print in JAMA Internal Medicine. 


Kasia J. Lipska, MD, of the Yale University School of Medicine in New Haven, Connecticut, and colleagues analyzed glycemic control levels in 1,288 adults (aged 65 years and older) with diabetes from the National Health and Nutrition Examination Survey (NHANES) from 2001 through 2010.

The patients were classified into three groups based on health status: very complex/poor (difficulty with two or more activities of daily living or being dependent on dialysis); complex/intermediate (difficulty with two or more instrumental activities of daily living or having three or more chronic conditions; and relatively healthy (if none of the other conditions was present). Tight glycemic control was an HbA1c level less than 7%.


Of the older adults with diabetes, 50.7% were relatively healthy, 28.1% had complex/intermediate health, and 21.2% had very complex/poor health, according to the researchers. Overall, 61.5% of the adults had an HbA1c level less than 7%, and this proportion did not differ across health status categories (62.8% were relatively healthy, 63% had complex/intermediate health, and 56.4% had very complex/poor health).

Of the adults with an HbA1c level less than 7%, 54.9% were treated with either insulin or sulfonylureas, and this proportion was similar across health status categories (50.8% were relatively healthy, 58.7% had complex/intermediate health, and 60% had very complex/poor health).